- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,516.00 / $5,845.00 / $10,686.00
| Facility | | $1,516.00 | $5,845.00 | $10,686.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.00 / $84.00 / $128.07
| Professional | | $84.00 | $84.00 | $128.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,264.00 / $12,274.00
| Facility | | $4,100.00 | $7,264.00 | $12,274.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.04 / $148.41 / $382.50
| Professional | | $117.04 | $148.41 | $382.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.89 / $205.89 / $16,534.50
| Facility | | $205.89 | $205.89 | $16,534.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.89 / $205.89 / $205.89
| Professional | | $205.89 | $205.89 | $205.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.58 / $184.58 / $7,227.90
| Facility | | $184.58 | $184.58 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $768.65 / $768.65 / $768.65
| Professional | | $768.65 | $768.65 | $768.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.18 / $189.29 / $327.22
| Professional | | $148.18 | $189.29 | $327.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.58 / $555.00 / $7,227.90
| Facility | | $184.58 | $555.00 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $768.65 / $768.65 / $768.65
| Professional | | $768.65 | $768.65 | $768.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,337.00 / $6,450.00 / $12,742.00
| Facility | | $2,337.00 | $6,450.00 | $12,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.75 / $201.38 / $469.90
| Professional | | $149.75 | $201.38 | $469.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.55 / $155.97 / $155.97
| Facility | | $141.55 | $155.97 | $155.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.97 / $155.97 / $327.22
| Professional | | $155.97 | $155.97 | $327.22 |